Planned SHSU med school aims to ease shortage of doctors...

1of 2Sam Houston State University is expected to break ground on a proposed College of Osteopathic Medicine in Conroe's Grand Central Park community by the end of 2018, according to developer Johnson Development Corp. The project consists of a five-story 216,000 square foot building on 7.3 acres on Interstate 45 just south of South Loop 336. Phase one of the building will be 108,000 square feet with surface parking.Photo: Johnson Development Corp.

2of 2Sam Houston State University is expected to break ground on a proposed College of Osteopathic Medicine in Conroe's Grand Central Park community by the end of 2018, Johnson Development Corp. announced. The project consists of a five-story 216,000 square foot building on 7.3 acres on Interstate 45 just south of South Loop 336. Phase one of the building will be 108,000 square feet with surface parking.Photo: Johnson Development Corp.

Sam Houston State University, which recently acquired more than seven acres in Conroe, is moving ahead with its plan to open a medical school in less than two years, aiming to ease a shortage of primary care physicians in East Texas — particularly in rural communities.

The school will train students in osteopathic medicine, a branch of the profession that takes a more holistic approach than traditional medicine. Dr. Charles Henley, the incoming dean of the medical school, said Sam Houston State chose to open its College of Osteopathic Medicine in large part because graduates were more likely to practice primary care medicine and center their practice in rural areas and places like East Texas, where a long-standing shortage of doctors is worsening and some patients must travel 100 miles or more to find care.

“East Texas is very far behind in access to health care," said Henley, a doctor of osteopathic medicine, or DO, who has practiced for about 40 years.

Sam Houston State University has pursued the medical school for about four years, choosing the Conroe location because no land was available on its main campus in Huntsville. The university in August received approval to open the medical school from the Texas Higher Education Coordinating Board, and last month accepted a gift of land from Johnson Development Corp., which donated a 7.3-acre parcel of land in Conroe's Grand Central Park, a master-planned community on I-45 just south of South Loop 336.

The school is awaiting accreditation from the Commission on Osteopathic College Accreditation in Chicago, but has tentatively scheduled the school to open in August 2020 with an initial enrollment of about 120 students.

Most medical schools in the United States teach traditional medicine, known as allopathic medicine, for which doctors receive their MDs. Osteopathic doctors receive the same education but they have a more holistic approach to practicing medicine. DOs also receive specific training in the musculoskeletal system and use manipulative treatment, which entails moving a patient's muscles and joints "using techniques that include stretching, gentle pressure and resistance," according to the Osteopathic Association.

There are 34 accredited osteopathic colleges in the United States, including two in Texas: The University of the Incarnate Word School of Osteopathic Medicine in San Antonio, and the Texas College of Osteopathic Medicine at the University of North Texas in Fort Worth. About 12 percent of medical students in Texas study osteopathic medicine.

Osteopathic physicians are accepted into the same residency programs as those who go through traditional medical programs. About 30 years ago, that wasn’t the case, but the the two branches of medicine are now coming closer together.

"They absolutely provide good care," said Dr. Janis Orlowski, the chief health care officer of Association of American Medical Colleges "They are part of the solution."

Primary care physicians are increasingly in short supply across the country as the population grows and ages. The Association of American Medical Colleges recently predicted that by 2030, the nation will experience a shortfall of between 14,800 and 49,300 primary care physicians.

In Texas, the Department of State Health Services estimates demand for primary care physicians in Texas will exceed supply every year between 2017 and 2030. In 2017, the state had a shortage of about 2,000 primary care physicians, which will increase by 67 percent, to nearly 3,400 by 2030.

Nowhere is that shortage felt more acutely than in rural communities. About 20 percent of the U.S. population lives in rural areas, but only 9 percent of doctors practice in those communities, according to the Association of American Medical Colleges. In the last few years alone, some 64 hospitals in the United States have closed, primarily in rural areas, Orlowski said.

In Texas, 80 of the state’s 254 counties have five or fewer physicians, according to Sam Houston State University.

Sam Houston State’s College of Osteopathic Medicine plans to recruit students from East Texas, with the idea they would be more likely to stay and practice in the region. But placing more doctors in rural practices requires more than just opening new medical schools, health care specialists said.

The profession is struggling with a shortage of residencies, the programs in which doctors train after graduating medical schools. Doctors tend to stay close to where they complete their residencies, as opposed to where they went to medical school, health care specialists said.

Dr. Douglas Curran, president of the Texas Medical Association, points to himself as an example He attended medical school in Arkansas, but completed his residency in Fort Worth. He has practiced in the East Texas city of Athens since 1979.

“Like most doctors, I ended up within 150 miles of where I did my residency,” Curran said. “That’s why it’s important to have good medical training in Texas.”

To get more doctors into rural communities, Curran said that the Legislature and the colleges themselves need to do more to create residencies in Texas. The federal government pays for the lion’s share of the nation’s residency programs, but Congress in 1997 placed a cap on such spending. Total federal spending on residencies is set at $15 billion annually.

The funding becomes problematic as new medical schools open and graduate more young doctors. In addition to Sam Houston State’s osteopathic school, two traditional medical schools are planning to open by 2020, the University of Houston College of Medicine, and a joint program by Texas Christian University and the University of North Texas Health Science Center in Fort Worth.

The Texas Medical Association forecasts the number of medical school graduates in the state will jump by nearly one-third by 2024, to more than 2,200 from about 1,700 last year, raising questions of whether they will be able to find residencies in the state.

Sam Houston State University said it plans to use federal funds, particularly those designated for rural areas, to create as many as 235 new residencies in East Texas. Germane Solutions, a consultancy working with SHSU, estimates $68 million to $92 million would be provided each year to participating East Texas hospitals.

“Doctors typically stay close to where their residencies were done,” Henley said, adding “we’d like to keep them here.”